Ministers welcome the report as a most helpful document. Our transplant programmes are already successful; for instance, the United Kingdom has more patients with a functioning kidney graft than any other country in Europe (nearly 7,000). However, this success has generated a need for more donor organs as increasing numbers of patients are considered suitable for this form of surgery. For this reason it is essential that the number of organ donors increases. The medical royal colleges' report rightly recognises that there is no single answer to the problem of improving the supply of donor organs. Many factors contribute to the shortfall and the report makes recommendations covering a number of areas.

The key recommendation is that each health authority should have an operational policy for organ donation, including procedures for identifying potential organ donors and recording the numbers so identified. The royal colleges believe that effective procedures would be preferable to a statutory system of required request such has been enacted in the United States of America. We accept this proposal, and with the health authorities are considering how such procedures might best be developed.

The report also recognises the value of good publicity. Many health authorities already have good arrangements for promoting donation, but we will be considering ways of extending the current initiatives, in the context of our discussions with the National Health Service.

The report contains many other recommendations. Some, such as the suggestion that district health authorities be reimbursed for the cost incurred in providing donor organs, are already being studied. Other recommendations affect bodies such as the royal colleges themselves and the European Community. The Department will be continuing consultations with the various bodies concerned to progress the ideas contained in the report.